围手术期急性肾损伤:当前的知识和麻醉师的作用

IF 0.4 Q3 MEDICINE, GENERAL & INTERNAL Proceedings of Singapore Healthcare Pub Date : 2023-03-15 DOI:10.1177/20101058231163406
Ji Xing, Samuel Kent Neng Loh
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引用次数: 0

摘要

在不同类型的围手术期器官损伤中,急性肾损伤(AKI)发生频繁,并始终与死亡率和死亡率增加相关。尽管开展了许多临床试验来评估围手术期干预措施,但仍然缺乏预防或逆转AKI的可靠方法。这篇叙述性综述讨论了最近关于可改变的危险因素的文献,目前的预防方法和未来研究的潜在方向。在Pubmed上用相关关键词搜索了最近10年发表的文章。为了预防围手术期AKI,对术前识别和优化、术中策略(包括麻醉选择、血流动力学和流体管理)有了新的认识。以患者为中心的多学科方法对于保护手术患者的肾功能至关重要。麻醉医师围手术期可以做很多事情,以降低AKI发展的风险,特别是在易感患者中。需要进一步的多中心试验来加强目前通用的围手术期推荐。
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Perioperative acute kidney injury: Current knowledge and the role of anaesthesiologists
Among the different types of perioperative organ injury, acute kidney injury (AKI) occurs frequently and is consistently associated with increased rates of mortality and mortality. Despite development of many clinical trials to assess perioperative interventions, reliable means to prevent or reverse AKI are still lacking. This narrative review discusses recent literature on modifiable risk factors, current approaches to prevention and potential directions for future research. A Pubmed search with the relevant keywords was done for articles published in the last 10 years. New insights into preoperative identification and optimisation, intraoperative strategies, including the choice of anaesthetic, haemodynamic and fluid management, have been made, with the aim of preventing perioperative AKI. A patient-centric multidisciplinary approach is essential to protect kidney function of patients going for surgery. Much can be done by anaesthesiologists perioperatively, to reduce the risk of development of AKI, especially in susceptible patients. There is a need for further multicentred trials to enhance the currently generic perioperative recommendations.
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来源期刊
Proceedings of Singapore Healthcare
Proceedings of Singapore Healthcare MEDICINE, GENERAL & INTERNAL-
CiteScore
0.90
自引率
0.00%
发文量
42
审稿时长
15 weeks
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